Studied by 16 people
based off pp
What regulates glucocorticoids? (This is suppressed when too many steroids are taken)
HPA axis
What are the main ADRs of corticosteroids?
immunosuppression
hyperglycemia
mood swings
adrenal suppression
What is adrenal suppression refer to?
When the HPA axis is suppressed due to exogenous supplementation of steroids.
What is the solution to avoiding adrenal suppression with steroids?
TAPER
You must taper steroids if a patient receives systemic corticosteroids ≥____ days with a prednisone equivalent of ≥_____mg.
14, 20
What are the glucocorticoids and their equivalent potencies?
Glucocorticoid | Equivalent potency (mg) |
Cortisone | 25 |
Hydrocortisone | 20 |
Prednisone | 5 |
Prednisolone | 5 |
Methylprednisolone | 4 |
Triamcinolone | 4 |
Dexamethasone | 0.75 |
Betamethasone | 0.6 |
What are some counseling points with corticosteroids?
take in the morning
give lowest dose for shortest duration
take with food
avoid abrupt discontinuation
Cushing’s Syndrome can be caused by exogenous and _____________ overproduction.
endogenous
What are the symptoms of cushing’s syndrome?
moon face
buffalo hump
weight gain
HTN
glucose intolerance
What 3 classes of medications can be used to treat cushing’s?
steroid synthesis inhibitors
ACTH inhibitors
Glucocorticoid receptor antagonists
What steroid synthesis inhibitors can be used in Cushing’s?
ketoconazole
etomidate
mitotane
metyrapone
What ACTH inhibitors can be used in Cushing’s?
cabergoline
pasireotide
What Glucocorticoid receptor antagonist is used to treat Cushing’s?
mifepristone
What are the symptoms of primary hyperaldosteronism?
hypernatremia
hypokalemia
HTN
muscle weakness/fatigue
HA
What is the main pharm tx for primary hyperaldosteronism?
spironolactone
What two symptoms are seen in primary adrenal insufficiency and not in secondary adrenal insufficiency?
hyperkalemia and hyperpigmentation
What are the symptoms of primary adrenal insufficiency or Addison’s disease?
bronze skin
low sugar
weight loss
postural hypotension
What glucocorticoids are preferred to treat Addison’s disease?
hydrocortisone
cortisone
prednisone
When dosing glucocorticoids for Addison’s disease, you should give _____% in the morning and ____% 6-8 hours later.
you should give 67% in the morning and 33% 6-8 hours later.
If you have Addison’s disease and are doing strenuous activities or exercise you should take ___-___mg hydrocortisone before.
5-10mg
In primary adrenal insufficiency or Addison’s disease what drug should be used to supplement mineralocorticoid loss?
fludrocortisone
What is the most common cause of an adrenal crisis?
abrupt steroid withdrawl
How do you treat an adrenal crisis?
100 mg IV bolus of hydrocortisone followed by continuous infusion for 24-48 hours
What medication can be used to treat hypoaldosteronism?
fludrocortisone
What is Hirsutism and how is it treated?
hirsutism is excessive hair growth in androgen-dependent distribution. treated with cosmetic approaches first (wax, shave) then 1st line is oral contraceptives.
Note 
Flashcard (105)